Parents

Cholesterol and Your Child

Most parents probably don't think about what cholesterol means for their kids. But high levels of cholesterol are a major factor contributing to heart disease and stroke, and medical research shows that cardiovascular disease has its roots in childhood. And with the dramatic increase in childhood obesity, more and more kids are at risk.

Problems associated with high cholesterol generally don't show up for years, so making the connection between kids' health and cholesterol can be difficult. But it's important to know your child's cholesterol levels, especially if there's a family history of high cholesterol or premature heart disease.

Identifying high cholesterol now will let you and your doctor work together to make changes that will lower your child's risk of developing heart disease later.

About Cholesterol

Cholesterol is a waxy substance produced by the liver. It's one of the lipids, or fats, the body makes and is used to form cell membranes and some hormones.

If you never ate another bowl of ice cream or another cheeseburger, your body would have enough cholesterol to run smoothly. That's because the liver makes enough for healthy body function. In fact, the liver produces about 1,000 milligrams of cholesterol a day. The rest comes from the foods we eat.

Although vegetables, fruits, and grains don't have any cholesterol, these foods from animals do:

Good vs. Bad Cholesterol

Cholesterol doesn't move through the body on its own. It has to combine with proteins to travel through the bloodstream to where it's needed. Cholesterol and protein traveling together are called lipoproteins.

Two kinds — low-density lipoprotein (LDL) and high-density lipoprotein (HDL) — are the ones that most of us have heard about.

Low-density lipoproteins, or "bad cholesterol," are the primary cholesterol carriers. Too much LDL in the bloodstream can build up on the walls of the arteries that lead to the heart and the brain. This buildup forms plaque — a thick, hard substance that can cause blood vessels to become stiffer, narrower, or blocked. Plaque buildup makes it easier for blood clots to form. If a blood clot forms and blocks a narrowed artery, the result can be a heart attack or stroke.

Atherosclerosis (hardening of the arteries) can also diminish blood flow to other vital organs, including the intestines or kidneys.

High-density lipoproteins, or "good cholesterol," carry cholesterol away from the arteries and back to the liver, where it's processed and sent out of the body, and might even help remove cholesterol from existing areas of plaque.

High levels of LDL increase the risk for heart disease and stroke, whereas high levels of HDL can help protect the circulatory system.

Kids who are physically active, eat healthy foods, don't have a family history of high cholesterol or heart disease, and aren't overweight have a lower risk for high cholesterol. Your doctor will help decide when your child's cholesterol level should be checked.

Your doctor can order a simple blood test, usually done fasting (nothing to eat or drink, except water, for 12 hours), to tell you if your child's cholesterol is too high. When screening healthy kids without risk factors, a non-fasting blood test can be used.

According to the National Cholesterol Education Program (NCEP) guidelines, the ranges of total and LDL cholesterol for kids and teens 2-18 years old are:

Category

Total cholesterol (mg/dL)

LDL cholesterol, (mg/dL)

Acceptable

Less than 170

Less than 110

Borderline

170-199

110-129

High

200 or greater

130 or greater

mg/dL = milligrams per deciliter

Children with LDL cholesterol levels 130 mg/dL or greater should receive individual nutritional counseling that focuses on reducing dietary fat and cholesterol and increasing physical activity. They should be tested again after 3 to 6 months of lifestyle intervention.

Medication might be considered for kids 10 and older with LDL cholesterol levels of 190 mg/dL or higher if changes in diet and exercise haven't worked. For kids with additional risk factors, treatment may be considered at even lower levels.

Choose from a variety of protein foods, including lean meats and poultry, fish, nuts, beans, peas, and soy products.

Read nutrition facts labels so that you can limit cholesterol and saturated and trans fat intake. The 2010 Dietary Guidelines recommend keeping dietary fat intake between 30%-40% for kids 1-3 years old and between 25%-35% for kids 4-18 years old, with most fats coming from sources of unsaturated fats (such as fish, nuts, and vegetable oils).

Encourage plenty of exercise. Exercise helps boost HDL levels in the blood — and that's a good thing! Kids and teens should be physically active at least 60 minutes a day.

Make living healthier a family affair. Kids usually aren't the only ones at risk, so it's important to make this a family effort. The steps you take to improve your family's lifestyle can have a positive effect on your family's health not only now, but far into the future.